This study aimed to assess the effects of lenvatinib (LEN) or sorafenib (SOR) treatment for hepatocellular carcinoma (HCC) on body composition and changes in body composition on survival. This study enrolled 77 HCC patients. Skeletal muscle index (SMI), subcutaneous and visceral adipose tissue indices (SATI and VATI), AFP, PIVKA-II, and ALBI scores were analyzed at the time of LEN/SOR introduction, three months after the introduction, at treatment discontinuation, and the last observational time. The differences between chronological changes in these values were analyzed using a pairedt-test. The Cox proportional hazards model was used to analyze prognostic factors using time-varying covariates. The chronological changes in each factor were 45.5–43.6–40.6–39.8 (cm2/m2) for SMI, 41.7–41.6–36.3–33.7 (cm2/m2) for SATI, 41.9–41.1–37.1–34.8 (cm2/m2) for VATI, 2.379–26.42–33.61–36.32 (×103ng/mL) for AFP, 9.404–13.39–61.34–25.70 (×103mAU/mL) for PIVKA-II, and −2.56–−2.38–−1.99–−1.90 for the ALBI score. The presence of pre-treatment (p= 0.042), AFP (p= 0.002), PIVKA-II (p< 0.001), ALBI score (p< 0.001), and SMI (p= 0.001) were independent prognostic factors. Skeletal muscle mass decreases significantly during LEN/SOR treatment and is an independent prognostic factor for HCC.
本研究旨在评估乐伐替尼（LEN）或索拉非尼（SOR）治疗肝细胞癌（HCC）对机体组成的影响，以及机体组成变化对生存率的影响。研究共纳入77例HCC患者。在LEN/SOR开始治疗时、治疗开始后三个月、治疗终止时及最后一次观察时间点，分别对骨骼肌指数（SMI）、皮下及内脏脂肪组织指数（SATI和VATI）、甲胎蛋白（AFP）、异常凝血酶原（PIVKA-II）及ALBI评分进行分析。采用配对t检验分析这些指标随时间变化的差异，并使用时变协变量的Cox比例风险模型分析预后因素。各指标随时间变化趋势如下：SMI为45.5–43.6–40.6–39.8（cm²/m²），SATI为41.7–41.6–36.3–33.7（cm²/m²），VATI为41.9–41.1–37.1–34.8（cm²/m²），AFP为2.379–26.42–33.61–36.32（×10³ ng/mL），PIVKA-II为9.404–13.39–61.34–25.70（×10³ mAU/mL），ALBI评分为−2.56–−2.38–−1.99–−1.90。多因素分析显示，治疗前状态（p=0.042）、AFP（p=0.002）、PIVKA-II（p<0.001）、ALBI评分（p<0.001）及SMI（p=0.001）是独立的预后影响因素。研究表明，LEN/SOR治疗期间骨骼肌质量显著下降，且骨骼肌质量是HCC的独立预后因素。
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